Most women are not satisfied with the counseling they receive about menopause. To improve menopausal counseling and help menopausal women more actively participate in the decision-making process, the applicant has developed a novel prototype web-based decision aid. The immediate goal of this project is to develop this prototype technology into a comprehensive Menopause Interactive Decision Aid System (MIDAS) that provides personalized feedback about menopausal symptoms, risks for common conditions, and the effects of different treatment options on the short- and long-term consequences of menopause. The main hypotheses of this study are that MIDAS can: 1) lead to better decisions and improve the quality of menopausal counseling; 2) improve compliance with a chosen menopausal plan; and 3) reduce medical errors associated with the use of menopausal therapies. The specific aims are to: 1) develop and optimize the utilization of MIDAS; 2) evaluate the impact of MIDAS on the decision-making process, including decisional conflict, knowledge, risk perception, anxiety, patient-physician communication, satisfaction with decision-making, the quality of menopause counseling, and medical errors related to menopausal therapy; and 3) evaluate the long-term impact of MIDAS on outcomes related to menopause. These endpoints include compliance with a chosen menopausal plan, quality of life, and providers' ability to manage menopausal patients. The applicant proposes a two-phase study conducted over three years. Phase I will transform the prototype application into a comprehensive MIDAS, completing its content and risk assessment instruments, and exploring its optimal design. This will be accomplished through conduct of focus groups and usability tests. Phase II will formally evaluate the impact of MIDAS in a randomized, controlled, multi-center clinical trial involving diverse patient populations and clinician settings. The impact of MIDAS on the decision-making process will be measured, as well as its effect on providers and outcome measures related to menopause, including compliance, quality of life, and medical errors related to menopausal therapy. Analyses will evaluate the extent to which the impact of MIDAS on these outcomes varies according to patient, practice, and physician characteristics.